Responding to the needs of refugees

Dear editor,

In their Christmas edition editorial, Arnold and colleagues outline their view on what is needed to respond to the health needs of refugees resettling in the UK (1). The authors highlight the UK government’s recent commitment to receive 20,000 refugees under the Vulnerable Person Relocation Scheme for Syrian nationals (VPRS) and outline the potentially complex – but largely predictable – health needs of this group. The authors argue that clinicians in the UK need to be prepared for these needs and suggest that this could be achieved by: providing a handheld medical record that follows each individual refugee to their new practitioner; ensuring that no inappropriate discrimination takes place at the point of care; and implementing a plan to train and support clinicians.

We fully agree with the need for these actions, which align closely with work currently being undertaken by Public Health England (PHE) and other key stakeholders to address health needs and improve the health of UK-bound and UK-resident refugees, asylum seekers and migrants.

In addition to the existing PHE’s Migrant Health Guide (2), PHE is currently leading the revision of guidance for the pre-entry health assessment, which is provided by designated doctors of the International Organisation of Migration (IOM) before refugees travel to the UK. This revision involves a consultation process with disease and migrant health experts, clinical commissioning groups, local authorities (LA), the Home Office (HO), the IOM and the NHS. This will help ensure that the pre-entry health assessment not only meets the needs of the refugee, but also appropriately reflects best practice and guarantees that appropriate information is collected to allow LAs and local health services to prepare for their arrival. This process is facilitated by an information flow working group, where PHE is collaborating closely with the HO, LAs, NHS England and the IOM to ensure that health related information reaches clinicians and relevant UK authorities both appropriately and safely, and can be used for monitoring and evaluation.

We also agree that support for health professionals who directly deal with the health of refugees, asylum seekers and migrants is critical. PHE has an established network of Migrant Health Leads – public health professionals based in regional PHE Centres who work closely with health professionals and local populations to promote refugee, asylum-seeker and migrant health in their areas. Migrant Health Leads have organised training activities and events, engaged with networks of community actors who promote refugee health and actively participated in the integration of refugees, asylum seekers and migrants in their community.

In collaboration with many other organisations, PHE continues to make an important contribution to the health of refugees, asylum seekers and migrants who are on their way or living in the UK. We believe it is worth highlighting the key role of public health and public health professionals in the complex scenario of resettling refugees and the existence of resources on the ground that can facilitate this task.

References

1. Arnold, F., Katona, C., Cohen, J., Jones, L., & McCoy, D. Responding to the needs of refugees. BMJ 2015;351:h6731
2. Health Protection Agency. Migrant Health Guide. [Online] 2014. Available from: http:/www.hpa.org.uk/MigrantHealthGuide/

Authors

Ines Campos-Matos, Public Health Speciality Registrar, Public Health England, London, United Kingdom
Dominik Zenner, Tuberculosis Section, Public Health England, London, United Kingdom
Gemma Smith, Travel and Migrant Health Section, Public Health England, London, United Kingdom
Paul Cosford, Director for Health Protection and Medical Director, Public Health England, London, United Kingdom
Hilary Kirkbride, Travel and Migrant Health Section, Public Health England, London, United Kingdom